NPR Reports C-123 Exposure Story on "All Things Considered"

Dayton-based Public Radio researcher Lewis Wallace expanded his initial January 28 story about C-123 Agent Orange issues into a report carried by National Public Radio on "All Things Considered."  (CLICK HERE for print version.)

Listeners heard Wallace in the Air Force Museum interview a former crewmember, as well as Mrs. Barbara Carson, widow of another C-123 vet, both from Rickenbacker Air Base in earlier years.Mrs. Carson has waited many years since first applying for survivor benefits which remain denied by the VA.

Also heard was Dr. Ralph Erickson, the VA physician chairing the committee of experts from Veterans Benefits Administration and Veterans Health Administration charged with recommending response to the January 9 Institute of Medicine report.

VA also told Wallace that any changes would take several months, but there was no suggestion of what sick C-123 veterans should do in the interim.

C-123 vets who are ill, all of whom are still refused VA care, should continue seeking medical attention elsewhere. Note there is no reimbursement for any such care. Once VA's plans to address C-123 needs are published, claims submitted will take a year or more to move through their system and veterans must anticipate providing for their own care during that period.

Survivors of C-123 veterans who die during the application process might be eligible for some residual benefits. Some C-123 veterans' claims have been denied and in appeal since 2007, and veterans and even their survivors have died in the interim...General Mike Walker is a painful example of this.

The IOM research, ordered by VA in early 2014, concluded that C-123 veterans of the 1972-1982 era, from Westover AFB MA, Pittsburgh AFS PA, and Rickenbacker ANGB OH, were exposed to Agent Orange residue in airplanes left after Vietnam. Print media also covering the issue included Scientific American, Reuters, LA Times, Washington Times, New York Times, and the AP.

That conclusion overturned VA arguments which had for years improperly blocked C-123 vets' disability claims, and clears the way for aircrews, aircraft maintenance and other veterans to seek Agent Orange benefits from the VA. Dr. Erickson's committee certainly has its hands full of a complex assignment, but we have maintained that all VA has to do is issue a training memo, rather than construct new regulations and other time-killing steps.

Present law, present regulations, present rules all fit perfectly...we now ask VA to follow its own rules in VAM21-1MR, and get our folks into the VA medical system as soon as possible, even if on an interim basis. Normally, such changes are announced in the Federal Register to allow for public comment...a process taking up to seven months.

Fortunately for C-123 veterans, VA has already made three separate Federal Register announcements assuring Congress that VA will treat veterans exposed to Agent Orange with the same presumptive service connection offered Vietnam veterans themselves. Any rule changes or Federal Register postings at this point would merely be announcements that VA will henceforth follow its own rules. Rules which they could use today and permit veterans to receive care, but for some reason additional delays are what VA does best.

Of course, there is significant savings for VA in denying medical care for these men and women for as long as possible, forcing them to seek attention through other insurance or Medicare program rather than in VA hospitals and clinics where lines are already long. While such savings aren't necessarily VA's primary objective in avoiding all C-123 veterans' care for even longer than the years already wasted, that fact works against, rather than for, C-123 veterans' health needs. If veterans pay, VA saves.

C-123 Veterans Association thanks Mr. Wallace and NPR for bringing our concerns to the American public.

VA & USAF Ignore Leading Agent Orange Expert on C-123 Exposure!

Hard to believe! Both the VA and the USAF opted to completely ignore the expert testimony of Dr. Jeanne Stellman, Professor Emerita at Columbia University's Mailman School of Public Health. Why...because it was her firm, expert opinion that our C-123 aircrews definitely were exposed to the deadly TCDD contaminants in Agent Orange when we flew those airplanes 1972-1982. She had to be ignored for the USAF and VA to reach contrary decisions...unless she was ignored her opinion would be emphatic

Professor Stellman

Why is it of concern? Because Dr. Stellman is the "go-to" expert who was relied on by the National Academies in their previous investigations...if her world-renowned expertise was so respected and authoritative in the IOM 2003 and other official reports, what is the excuse used by the VA and the USAF in ignoring her detailed explanation of our exposure aboard the C-123?

Answer: It is the only way to prevent our veterans gaining service-connection and recognition for our exposure. If the authorities were to fairly evaluate Professor Stellman's findings their barrier against allowing us to receive VA medical care disappears!

Background: Because of continuing uncertainty about the long-term health effects of the sprayed herbicides on Vietnam veterans, Congress passed the Agent Orange Act of 1991. The legislation directed the Secretary of Veterans Affairs to request the IOM to perform a comprehensive evaluation of scientific and medical information regarding the health effects of exposure to Agent Orange and other herbicides used in Vietnam. Congress had grown tired of the VA's posturing and delaying tactics, so legislation was passed to get them moving.

The IOM formed their Committee on Agent Orange. That committee of medical and scientific experts searched for the most outstanding scientific advice and quickly identified Professor Jeanne Stellman as their trusted  researcher to make appropriate findings and recommendations. In the Committee's 2003 report, Professor Stellman detailed the problems with dioxin, the means of exposure and the best ways to perform epidemiological studies to advance understanding of that toxin's impact on veterans.

Conclusion: So you cannot avoid seeing the conundrum. Stellman...expert enough for Congress. Stellman...expert enough for the Institute on Medicine. Stellman...expert enough for the Committee on Agent Orange. Stellman...one of the top two or three published scientists in this field. But magically...only in Stellman's finding that our aircrews were exposed does her expertise seem to fall short of the threshold necessary for the VA to accept our exposure to have been"as likely to as not". Further, it is impossible to ignore the VA's broken promise, made in our face-to-face meeting with their representatives (VA Public Health) hosted by Senator Burr (NC) in which the issue of our exposure was to be put to the IOM as a special project.

Ever-eager to prevent even a single veteran's access to essential medical care for Agent Orange illnesses, the VA leaped on the Air Force's faulty C-123 literature review, in which the AF said they were unable to reach a definite conclusion about exposure, so the VA took that piece of confused and twisted double-talk to use against us and canceled their promised IOM study. That move was to keep IOM from turning to their trusted expert, Dr. Stellman, who had already voiced her opinion about our exposure in her pivotal 2011 letter.

So let's look at a balance sheet of evidence regarding C-123 aircrew dioxin exposure: On the left, those who weigh in on our having been exposed, and on the right. those who weigh in on an opinion that we haven't been exposed. Judge for yourself! And consider why the opponents of our claim for AO exposure are so dedicated to saving money by preventing access to medical care, and not to fairly considering our situation!

AF Surgeon's Office Briefs Sen. Burr's Staff & C-123 Veterans

Yesterday, a very well prepared team from the AF Surgeon's Office briefed Senator Burr's staff  about their 27 April 2012 report dealing with C-123 aircrew dioxin exposure. A lot of effort went into their participation and the C-123 Veterans Association extends thanks to the Air Force Surgeon General as well as Senator Burr's staff.

Joining the teleconference were Dr. Richard Clapp (Professor Emeritus Boston University School of Public Health) and Dr. Jeanie Stellman (Professor Emerita Columbia University Mailman School of Public Health). These dedicated scientists, so familiar with Agent Orange issues, helped C-123 veterans better understand both the Air Force report and the earlier VA report.

During this meeting, the Air Force briefers explained:

• the report was prepared by "tens" of experts from various health professions assigned to the Air Force School of Aerospace Medicine, Wright-Patterson AFB, Ohio. Released over the signature of USAFSAM's commander, the report correctly reflects the professional opinion of each of the various experts who contributed to it. Drafts of earlier versions or of the final staff report submitted to USAFSAM/CC prior to the published version will not be made available
• USAFSAM undertook the project partly to gather all relevant information, provide an analysis, and make it all available to the public
• complete and thorough release of materials from all Air Force sources was provided; no documents were withheld from USAFSAM researchers by any source, including Davis-Monthan and Hill.
• USAFSAM was unable to determine any particular individual or group exposure, lacking an adequate population for an epidemiological study and having to rely on reports done over the decades since concerns first surfaced about C-123 Agent Orange contamination (the aircraft having been since destroyed)
• the briefers twice stressed their report was unable to make a finding about whether or not individual or occupational groups were exposed. Yet in very stark contrast to that claim of indecision or neutrality, the report reads "At this time, we conclude that the discernible information suggests the potential Agent Orange exposures...were unlikely to have exceeded acceptable regulatory standards or to have predisposed persons in either group to experience future adverse outcomes."
• the executive summary's finding of "unlikely" exposure contrasts with the report's conclusion in 4(d), "is is reasonable to conclude that it is not possible to derive quantitative estimates of any increased health risks for those individuals". If that is the case, why did the report earlier deny any likelihood of such exposure? Shouldn't any such indecision result in the benefit of the doubt given the veterans?
• the pivotal 1994 Weisman/Porter survey of Patches for the Air Force Museum concluded the aircraft was "heavily contaminated" but from the perspective of extensive restoration (grinding, ripping out insulation, fabric, etc.)
• the Air Force briefers suggest the report was not written for guidance of other agencies, such as the Veterans Administration, and that the VA would likely evaluate C-123 veterans' claims "on an individual basis." We explained that VA has already cited the AF report as decisive evidence against C-123 veterans' exposure to dioxin and as justification for denying service connection.

Dr. Clapp stressed that the VA and AF need to discuss the issue in a manner similar to the effort he assists at Camp Lejeune, and find an avenue for individual claims to be evaluated more effectively. Dr. Stellman stressed the importance of remembering the tests' confirmation of "military herbicides" and the need to treat C-123 veterans with the same logic, the same fairness, as the VA has treated Vietnam veterans.

Mr. Tucker of Senator Brook's staff stressed that federal agencies need to find a more compassionate approach to evaluation of individual C-123 veterans' dioxin exposure, and that a reasonable benefit of the doubt be applied to the situation.

For C-123 veterans, the day did not go well. Air Force briefers were enthusiastic in presentation of the report and defensive about its conclusions. Although the briefing began with a general statement that their report was unable to reach a conclusion regarding "occupational" exposure, no retreat was made from the actual wording of the report's Executive Summary which states exposure was "unlikely."

Air Force leadership should know that C-123 veterans are respectful of their authority, and we are absolutely dedicated to the Air Force mission and core values. Given our age, these values have been part of our lives longer than with those currently serving.

We differ in our opinions regarding aircrew dioxin exposure and trust that future peer-reviewed articles in professional journals will better articulate the basis for our actual and harmful exposure and qualification for VA service connection. We also hope for continued support from universities and federal agencies such as the ATSDR.